tbuckley/cabot-search huggingface dataset:
Association of Glucose-Lowering Drugs With Outcomes in Patients With Diabetes Before Hospitalization for COVID-19
Authors: Zheng Zhu, Qingya Zeng, Qinyu Liu, Junping Wen, Gang Chen
Journal: JAMA Network Open (2022)

Importance Patients with COVID-19 have a high prevalence of diabetes, and diabetes and blood glucose control are determinants of intensive care unit admission and mortality. Objective To evaluate the association between COVID-19–related adverse outcomes and 8 antihyperglycemic drugs in patients with diabetes who were subsequently diagnosed and hospitalized with COVID-19. Data Sources Data were retrieved and collected in PubMed, Embase, Cochrane Central Register, Web of Science, and ClinicalTrials.gov from database inception to September 5, 2022. Study Selection For this systematic review and network meta-analysis, randomized clinical trials and observational studies conducted among patients with diabetes while receiving glucose-lowering therapies for at least 14 days before the confirmation of COVID-19 infection were included after blinded review by 2 independent reviewers and consultations of disagreement by a third independent reviewer. Of 1802 studies initially identified, 31 observational studies met the criteria for further analysis. Data Extraction and Synthesis This study follows the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline. Bayesian network meta-analyses were performed with random effects. Main Outcomes and Measures A composite adverse outcome, including the need for intensive care unit admission, invasive and noninvasive mechanical ventilation, or in-hospital death. Results Thirty-one distinct observational studies (3 689 010 patients with diabetes hospitalized for COVID-19) were included. The sodium-glucose cotransporter-2 inhibitors (SGLT-2is) were associated with relatively lower risks of adverse outcomes compared with insulin (log of odds ratio [logOR], 0.91; 95% credible interval [CrI], 0.57-1.26), dipeptidyl peptidase-4 inhibitors (logOR, 0.61; 95% CrI, 0.28-0.93), secretagogues (logOR, 0.37; 95% CrI, 0.02-0.72), and glucosidase inhibitors (logOR, 0.50; 95% CrI, 0.00-1.01). Based on the surface under the cumulative ranking curves value, SGLT-2is were associated with the lowest probability for adverse outcomes (6%), followed by glucagon-like peptide-1 receptor agonists (25%) and metformin (28%). A sensitivity analysis revealed that the study was reliable. Conclusions and Relevance These findings suggest that the use of an SGLT-2i before COVID-19 infection is associated with lower COVID-19–related adverse outcomes. In addition to SGLT-2is, glucagon-like peptide-1 receptor agonists and metformin were also associated with relatively low risk of adverse outcomes.
Final Results for Study of Transvaginal Mesh for Pelvic Organ Prolapse
Authors: Howard D. Larkin
Journal: JAMA (2022)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Identification, validation and biological characterisation of novel glioblastoma tumour microenvironment subtypes: implications for precision immunotherapy
Authors: K. White, K. Connor, M. Meylan, A. Bougoüin, M. Salvucci, F. Bielle, A.C. O’Farrell, K. Sweeney, L. Weng, G. Bergers, P. Dicker, D.M. Ashley, E.S. Lipp, J.T. Low, J. Zhao, P. Wen, R. Prins, M. Verreault, A. Idbaih, A. Biswas, J.H.M. Prehn, D. Lambrechts, I. Arijs, F. Lodi, G. Dilcan, M. Lamfers, S. Leenstra, F. Fabro, I. Ntafoulis, J.M. Kros, J. Cryan, F. Brett, E. Quissac, A. Beausang, S. MacNally, P. O’Halloran, J. Clerkin, O. Bacon, A. Kremer, R.T. Chi Yen, F.S. Varn, R.G.W. Verhaak, C. Sautès-Fridman, W.H. Fridman, A.T. Byrne
Journal: Annals of Oncology (2022)

New precision medicine therapies are urgently required for glioblastoma (GBM). However, to date, efforts to subtype patients based on molecular profiles have failed to direct treatment strategies. We hypothesised that interrogation of the GBM tumour microenvironment (TME) and identification of novel TME-specific subtypes could inform new precision immunotherapy treatment strategies.A refined and validated microenvironment cell population (MCP) counter method was applied to >800 GBM patient tumours (GBM-MCP-counter). Specifically, partition around medoids (PAM) clustering of GBM-MCP-counter scores in the GLIOTRAIN discovery cohort identified three novel patient clusters, uniquely characterised by TME composition, functional orientation markers and immune checkpoint proteins. Validation was carried out in three independent GBM-RNA-seq datasets. Neoantigen, mutational and gene ontology analysis identified mutations and uniquely altered pathways across subtypes. The longitudinal Glioma Longitudinal AnalySiS (GLASS) cohort and three immunotherapy clinical trial cohorts [treatment with neoadjuvant/adjuvant anti-programmed cell death protein 1 (PD-1) or PSVRIPO] were further interrogated to assess subtype alterations between primary and recurrent tumours and to assess the utility of TME classifiers as immunotherapy biomarkers.TMEHigh tumours (30%) displayed elevated lymphocyte, myeloid cell immune checkpoint, programmed cell death protein 1 (PD-1) and cytotoxic T-lymphocyte-associated protein 4 transcripts. TMEHigh/mesenchymal+ patients featured tertiary lymphoid structures. TMEMed (46%) tumours were enriched for endothelial cell gene expression profiles and displayed heterogeneous immune populations. TMELow (24%) tumours were manifest as an 'immune-desert' group. TME subtype transitions upon recurrence were identified in the longitudinal GLASS cohort. Assessment of GBM immunotherapy trial datasets revealed that TMEHigh patients receiving neoadjuvant anti-PD-1 had significantly increased overall survival (P = 0.04). Moreover, TMEHigh patients treated with adjuvant anti-PD-1 or oncolytic virus (PVSRIPO) showed a trend towards improved survival.We have established a novel TME-based classification system for application in intracranial malignancies. TME subtypes represent canonical 'termini a quo' (starting points) to support an improved precision immunotherapy treatment approach.
Association of Outpatient Behavioral Health Treatment With Medical and Pharmacy Costs in the First 27 Months Following a New Behavioral Health Diagnosis in the US
Authors: Johanna Bellon, Carol Quinlan, Beth Taylor, Douglas Nemecek, Eva Borden, Priya Needs
Journal: JAMA Network Open (2022)

Importance Outpatient behavioral health treatment (OPBHT) is an effective treatment for behavioral health conditions (BHCs) that may also be associated with improved medical health outcomes, but evidence regarding the cost-effectiveness of OPBHT across a large population has not been established. Objective To investigate whether individuals newly diagnosed with a BHC who used OPBHT incurred lower medical and pharmacy costs over 15 and 27 months of follow-up compared with those not using OPBHT. Design, Setting, and Participants This retrospective cohort study of commercially insured individuals in the US was conducted using administrative insurance claims data for individuals newly diagnosed with 1 or more BHCs between January 1, 2017, and December 31, 2018. Data were examined using a 12-month period before BHC diagnosis and 15- and 27-month follow-up periods. Participants included individuals aged 1 to 64 years who received any OPBHT with or without behavioral medication or who did not receive OPBHT or behavioral medication in the 15 months following diagnosis. Data were analyzed from May to October 2021. Exposures Receipt of OPBHT both as a dichotomous variable and categorized by number of OPBHT visits. Main Outcomes and Measures The main outcome was the association between OPBHT treatment and 15- and 27-month medical and pharmacy costs, assessed using a generalized linear regression model with γ distribution, controlling for potential confounders. Results The study population included 203 401 individuals, of whom most were male (52%), White, non-Hispanic (75%), and 18 to 64 years of age (67%); 22% had at least 1 chronic medical condition in addition to a BHC. Having 1 or more OPBHT visits was associated with lower adjusted mean per-member, per-month medical and pharmacy costs across follow-up over 15 months (no OPBHT: $686 [95% CI, $619-$760]; ≥1 OPBHT: $571 [95% CI, $515-$632]; P &amp;amp;lt; .001) and 27 months (no OPBHT: $464 [95% CI, $393-$549]; ≥1 OPBHT: $391 [95% CI, $331-$462]; P &amp;amp;lt; .001). Furthermore, almost all doses of OPBHT across the 15 months following diagnosis were associated with lower costs compared with no OPBHT. Conclusions and Relevance In this cohort study, medical cost savings were associated with OPBHT among patients newly diagnosed with a BHC in a large, commercially insured population. The findings suggest that promoting and optimizing OPBHT may be associated with reduced overall medical spending among patients with BHCs.
Antibiotic Cycling Affects Resistance Evolution Independently of Collateral Sensitivity
Authors: Pauline Brepoels, Kenny Appermans, Camilo Andres Pérez-Romero, Bram Lories, Kathleen Marchal, Hans P Steenackers
Journal: Molecular Biology and Evolution (2022)

Antibiotic cycling has been proposed as a promising approach to slow down resistance evolution against currently employed antibiotics. It remains unclear, however, to which extent the decreased resistance evolution is the result of collateral sensitivity, an evolutionary trade-off where resistance to one antibiotic enhances the sensitivity to the second, or due to additional effects of the evolved genetic background, in which mutations accumulated during treatment with a first antibiotic alter the emergence and spread of resistance against a second antibiotic via other mechanisms. Also, the influence of antibiotic exposure patterns on the outcome of drug cycling is unknown. Here, we systematically assessed the effects of the evolved genetic background by focusing on the first switch between two antibiotics against Salmonella Typhimurium, with cefotaxime fixed as the first and a broad variety of other drugs as the second antibiotic. By normalizing the antibiotic concentrations to eliminate the effects of collateral sensitivity, we demonstrated a clear contribution of the evolved genetic background beyond collateral sensitivity, which either enhanced or reduced the adaptive potential depending on the specific drug combination. We further demonstrated that the gradient strength with which cefotaxime was applied affected both cefotaxime resistance evolution and adaptation to second antibiotics, an effect that was associated with higher levels of clonal interference and reduced cost of resistance in populations evolved under weaker cefotaxime gradients. Overall, our work highlights that drug cycling can affect resistance evolution independently of collateral sensitivity, in a manner that is contingent on the antibiotic exposure pattern.
Efficacy and safety of transcranial magnetic stimulation for treating major depressive disorder: An umbrella review and re-analysis of published meta-analyses of randomised controlled trials
Authors: S. Brini, N.I. Brudasca, A. Hodkinson, K. Kaluzinska, A. Wach, D. Storman, A. Prokop-Dorner, P. Jemioło, M.M. Bala
Journal: Clinical Psychology Review (2022)

We re-analysed data from published meta-analyses testing the effects of Transcranial Magnetic Stimulation (TMS) on Major Depressive Disorder (MDD) in adults. We applied up-to-date meta-analytic techniques for handling heterogeneity including the random-effects Hartung-Knapp-Sidik-Jonkman method and estimated 95% prediction intervals. Heterogeneity practices in published meta-analyses were assessed as a secondary aim. We performed systematic searches of systematic reviews with meta-analyses that included randomised controlled trials assessing the efficacy, tolerability, and side effects of TMS on MDD. We performed risk of bias assessment using A MeaSurement Tool to Assess Reviews (AMSTAR) 2 and re-analysed meta-analyses involving 10 or more primary studies. We included 29 systematic reviews and re-analysed 15 meta-analyses. Authors of all meta-analyses interpreted findings to suggest TMS is safe and effective for MDD. Our re-analysis showed that in 14 out of 15 meta-analyses, the 95% prediction intervals included the null and captured values in the opposite effect direction. We also detected presence of small-study effects in some meta-analyses and 24 out of 25 systematic reviews received an AMSTAR 2 rating classed as critically low. Authors of all included meta-analyses interpreted findings to suggest TMS is safe and effective for MDD despite lack of comprehensive investigation of heterogeneity. Our re-analysis revealed the direction and magnitude of treatment effects vary widely across different settings. We also found high risk of bias in the majority of included systematic reviews and presence of small-study effects in some meta-analyses. Because of these reasons, we argue TMS for MDD may not be as effective and potentially less tolerated in some populations than current evidence suggests.
Immunogenicity of three versus four doses of 13-valent pneumococcal conjugate vaccine followed by 23-valent pneumococcal polysaccharide vaccine in allogeneic haematopoietic stem cell transplantation recipients: a multicentre, randomized controlled trial
Authors: Keiji Okinaka, Yukihiro Akeda, Yoshihiro Inamoto, Shigeo Fuji, Ayumu Ito, Takashi Tanaka, Saiko Kurosawa, Sung-Won Kim, Ryuji Tanosaki, Takuya Yamashita, Chikako Ohwada, Keiji Kurata, Takeshi Mori, Masahiro Onozawa, Kuniko Takano, Hiroki Yokoyama, Katsuyoshi Koh, Koji Nagafuji, Kazutaka Nakayama, Toru Sakura, Tsutomu Takahashi, Kazunori Oishi, Takahiro Fukuda
Journal: Clinical Microbiology and Infection (2022)
3D‐Printed Radiopaque Bioresorbable Stents to Improve Device Visualization (Adv. Healthcare Mater. 23/2022)
Authors: Yonghui Ding, Rao Fu, Caralyn Paige Collins, Sarah‐Fatime Yoda, Cheng Sun, Guillermo A. Ameer
Journal: Advanced Healthcare Materials (2022)

Bioresorbable Stents In article 2201955, Cheng Sun, Guillermo A. Ameer, and co-workers report a method to confer X-ray contrast to 3D printed polymeric bioresorbable stents (BRS) through the incorporation of the clinically used contrast agent iodixanol into a citrate-based polymer ink. The 3D-printed BRS has strong X-ray visibility, mechanical competence, and excellent in vitro biocompatibility, characteristics that are important for successful clinical use.
NIR‐Assisted MgO‐Based Polydopamine Nanoparticles for Targeted Treatment of Parkinson's Disease through the Blood–Brain Barrier (Adv. Healthcare Mater. 23/2022)
Authors: Yifei Gao, Yuxue Cheng, Jiapeng Chen, Danmin Lin, Chao Liu, Ling‐Kun Zhang, Liang Yin, Runcai Yang, Yan‐Qing Guan
Journal: Advanced Healthcare Materials (2022)

Parkinson's Disease In article 2201655, Yan-Qing Guan and co-workers successfully develop a novel photo-controlled drug delivery system for the treatment of Parkinson's disease. This nanoparticle uses MgO nanoparticles as a substrate, polydopamine as a shell and carries anti-SNCA plasmid and puerarin. Under the irradiation of 808 nm near-infrared light, the composite nanoparticles in deep tissues are activated, then absorbed by nerve cells after penetrating the blood–brain barrier, playing the role of antioxidation, anti-inflammation and inhibiting the accumulation of α-synuclein. Therefore, this strategy for intracerebral drug delivery can be an ideal approach to combat neurodegenerative diseases.
Totally Organic Hydrogel‐Based Self‐Closing Cuff Electrode for Vagus Nerve Stimulation (Adv. Healthcare Mater. 23/2022)
Authors: Daigo Terutsuki, Hayato Yoroizuka, Shin‐ichiro Osawa, Yuka Ogihara, Hiroya Abe, Atsuhiro Nakagawa, Masaki Iwasaki, Matsuhiko Nishizawa
Journal: Advanced Healthcare Materials (2022)

Vagus Nerve Stimulation In article 2201627 by Matsuhiko Nishizawa and co-workers, a totally organic hydrogel-based cuff-type stimulation electrode with self-closing properties is developed. The cuff electrode is spontaneously immobilized to the vagus nerve by wrapped around the nerve bundle with harmless pressure. The organic nature of the electrode is compatible with MRI imaging.
Alleviating experimental pulmonary hypertension via co-delivering FoxO1 stimulus and apoptosis activator to hyperproliferating pulmonary arteries
Authors: Bingbing Li, Chao Teng, Huiling Yu, Xiaohong Jiang, Xuyang Xing, Qi Jiang, Chenshi Lin, Zongmin Zhao, Ruifeng Zhang, Wei He
Journal: Acta Pharmaceutica Sinica B (2022)

Pulmonary hypertension (PH) is an insidious pulmonary vasculopathy with high mortality and morbidity and its underlying pathogenesis is still poorly delineated. The hyperproliferation and apoptosis resistance of pulmonary artery smooth muscle cells (PASMCs) contributes to pulmonary vascular remodeling in pulmonary hypertension, which is closely linked to the downregulation of fork-head box transcriptional factor O1 (FoxO1) and apoptotic protein caspase 3 (Cas-3). Here, PA-targeted co-delivery of a FoxO1 stimulus (paclitaxel, PTX) and Cas-3 was exploited to alleviate monocrotaline-induced pulmonary hypertension. The co-delivery system is prepared by loading the active protein on paclitaxel-crystal nanoparticles, followed by a glucuronic acid coating to target the glucose transporter-1 on the PASMCs. The co-loaded system (170 nm) circulates in the blood over time, accumulates in the lung, effectively targets the PAs, and profoundly regresses the remodeling of pulmonary arteries and improves hemodynamics, leading to a decrease in pulmonary arterial pressure and Fulton's index. Our mechanistic studies suggest that the targeted co-delivery system alleviates experimental pulmonary hypertension primarily via the regression of PASMC proliferation by inhibiting cell cycle progression and promoting apoptosis. Taken together, this targeted co-delivery approach offers a promising avenue to target PAs and cure the intractable vasculopathy in pulmonary hypertension.
Deep reinforcement learning for cerebral anterior vessel tree extraction from 3D CTA images
Authors: Jiahang Su, Shuai Li, Lennard Wolff, Wim van Zwam, Wiro J. Niessen, Aad van der Lugt, Theo van Walsum
Journal: Medical Image Analysis (2022)

Extracting the cerebral anterior vessel tree of patients with an intracranial large vessel occlusion (LVO) is relevant to investigate potential biomarkers that can contribute to treatment decision making. The purpose of our work is to develop a method that can achieve this from routinely acquired computed tomography angiography (CTA) and computed tomography perfusion (CTP) images. To this end, we regard the anterior vessel tree as a set of bifurcations and connected centerlines. The method consists of a proximal policy optimization (PPO) based deep reinforcement learning (DRL) approach for tracking centerlines, a convolutional neural network based bifurcation detector, and a breadth-first vessel tree construction approach taking the tracking and bifurcation detection results as input. We experimentally determine the added values of various components of the tracker. Both DRL vessel tracking and CNN bifurcation detection were assessed in a cross validation experiment using 115 subjects. The anterior vessel tree formation was evaluated on an independent test set of 25 subjects, and compared to interobserver variation on a small subset of images. The DRL tracking result achieves a median overlapping rate until the first error (1.8 mm off the reference standard) of 100, [46, 100] % on 8032 vessels over 115 subjects. The bifurcation detector reaches an average recall and precision of 76% and 87% respectively during the vessel tree formation process. The final vessel tree formation achieves a median recall of 68% and precision of 70%, which is in line with the interobserver agreement.
Treatment of Patients after Pulmonary Vein Isolation in Persistent Atrial Fibrillation - Combined Use of a High-Density Map and Robotic Navigation
Authors: Yuriy Bychkov, Zdravena Doneva, Björn Buchter, Margarita Kreuzer, P. Christian Schulze, Burkhard Hügl
Journal: Clinical Cardiology and Cardiovascular Interventions (2022)

Objectives and Background: Atrial fibrillation (AF) is still associated with higher recurrence rate. This is prospective study of Redo pulmonary vein isolation (PVI) combined with remote magnet navigation. We have done high density mapping and in retrospective Analysis we tried to find criteria for better Ablation success. Materials and Methods: 50 patients (male 36, female 14) with indication for Redo-PVI ware included. A 20 polig multielectrode catheter was used for mapping. Mapping data were collected bevor and after ablation and processed in terms of low-voltage areas bipolar (3 groups: 0.05-0.15 mV, 0.15-0.25 mV, 0.25-0.5 mV) and change in unipolar amplitude at the ablation lesions. The primary endpoint (symptom freedom at 12 months) was evidenced by follow-up examinations at 3, 6,9,12 months. Non-parametric statistical methods were used for variables with non-normal distributions. Trends in success rates were evaluated using the Kaplan-Meier methodology and compared using a log-ranking test. Results: In all analysed low-voltage bipolar groups occurs a change in the distribution after ablation in patients with AF. There are 3 parameters which related with endpoint: area of bipolar signals 0.05-0.15 mV (Me +32%, [95% CI: -10% to +167%], p&lt;0.001), the unipolar amplitude at the applied ablation lesions (Me -0.45mV [95% CI: -0.15 to -1], p&lt;0,001) and unipolar amplitude at the attached ablation lesions (lower amplitude was with recurrence associated, p=0.004). According to ROC analysis and logistic regression: failure to meet all 3 criteria accompanied with a 67% probability of symptomatic recurrence, if all 3 criteria are met, it is expected to have an approximately 81% success rate within the 12 months. Conclusion: Analysis of a high-density map including 3 criteria, help us to improve ablation success.
Immune Checkpoint Inhibitor Mediated Myocarditis: A Case Report
Authors: Carrie L Cicirale
Journal: Clinical Cardiology and Cardiovascular Interventions (2022)

This is a case report describing an 83-year-old male with suspected immune checkpoint inhibitor mediated myocarditis after two cycles of ipilimumab and nivolumab. The patient was treated with intravenous (IV) steroids after other common causes of his symptoms were ruled out. While the patient’s lab values reflected a slight treatment response, ultimately the patient expired due to progression of symptoms. Myocarditis due to immune checkpoint inhibitor therapy is a rare but fatal occurrence, and more data is needed to determine the optimal treatment and dosing strategy.